Infectious Diseases News Brief - August 27, 2010

[Current Issue -Table of contents]

Pediatric Pneumococcal Serotypes in 4 European Countries

After heptavalent pneumococcal conjugate vaccine (PCV7) was marketed in France, Spain, Belgium, and England and Wales (United Kingdom), invasive disease from non-PCV7 serotypes (NVT) increased. Adjusted serotype-specific incidences among children <15 years of age were compared between 1999–2002 (prevaccine) and 2005–2006 (postmarketing). Vaccine coverage increased to ≈32%–48% in France, Spain, and Belgium but remained <1% in England and Wales. Serotype 1 incidence rose in all age groups and countries (incidence rate ratio [IRR] 1.3–4.2; p<0.004), independently of PCV7 use, but incidence of serotypes 7F and 19A increased most in France, Spain, and Belgium (IRR 1.9–16.9 in children <5 years; p<0.001), where PCV7 coverage was greater. Vaccine-induced replacement of PCV7 serotypes possibly contributed to NVT increases, as did secular trends. New vaccines targeting these serotypes are available, but serotype dynamics needs further exploration that accounts for underreporting and prevaccine trends. Streptococcus pneumoniae is a leading cause of meningitis and septicemia worldwide. More than 90 serotypes have been identified for S. pneumoniae, but serotype distribution differs by area and changes over time. The heptavalent pneumococcal conjugate vaccine (PCV7) targets the 7 serotypes–4, 6B, 9V, 14, 18C, 19F, and 23F–that most commonly caused pediatric invasive pneumococcal disease (IPD) in the United States. Widespread PCV7 use in the United States since 2000 led to rapid and dramatic decreases in vaccine serotypes and an overall decrease of IPD incidence.

Source: Emerging Infectious Diseases Journal, volume 16, number 9 - September 2010
http://www.cdc.gov/eid/content/16/9/1428.htm#1

A 10-year retrospective review of Salmonella infections at the Children's Hospital in London, Ontario

Objectives: To describe Salmonella infections in children presenting to the Children’s Hospital (London Health Sciences Centre, London, Ontario), to assess risk factors for infection and to examine whether younger children, particularly infants younger than 12 weeks of age, experience higher morbidity than older children.

Methods: A 10-year retrospective review of children with Salmonella infections at the Children’s Hospital was conducted. Patient demographics, risk factors for infection, clinical characteristics, bacteriology and outcome were collected from the hospital charts and laboratory records. Data were separated into groups based on age and recent use of antibiotics to analyze differences in outcomes.

Results: Sixty-six children with Salmonella infections presented to the Children’s Hospital over a 10-year period. Common risk factors for Salmonella infection included having sick contacts, living in a rural area, recent travel, contact with pets (especially reptiles) and exposure to local water. Younger age was associated with an increased likelihood of admission to hospital, treatment with antibiotics and a longer course of antibiotic therapy. This was true when comparing older infants with those younger than 12 weeks of age. Patients recently treated with antibiotics and those with significant underlying medical conditions were more likely to be admitted.

Conclusions: A wider knowledge of the epidemiological risk factors for Salmonella infection may improve diagnosis. Higher admission rates were expected in children younger than 12 weeks of age, those recently treated with antibiotics and those who had a significant underlying medical condition. A prospective, multicentre study is needed to further address questions regarding increased illness severity and appropriate management of Salmonella infections in children younger than 12 weeks of age.

Source: The Canadian Journal of Infectious Diseases and Medical Microbiology, Summer 2010, volume 21 Issue 2:78-82 http://www.pulsus.com/journals/abstract.jsp?sCurrPg=abstract&jnlKy=3&atlKy=9511&isuKy=917&isArt=t&fromfold=Current%20Issue